(a) There is no internationally accepted definition for “aesthetic medical practice”. For the purpose of these guidelines it is defined as:

An area of medical practice which embraces multidisciplinary modalities dedicated to create a harmonious physical and psychological balance through non-invasive, minimally invasive and invasive treatment modalities which are evidence-based. These modalities focus on the anatomy, physiology of the skin and its underlying structures, to modify the otherwise „normal‟ (non-pathological) appearance in order to satisfy the goals of the patient and are carried out by registered medical practitioners.

(b) “registered medical practitioner” is defined as a medical practitioner who is registered and holds a valid practising certificate under the Medical Act 1971 [Act 50]

3.0 CLASSIFICATION OF AESTHETIC MEDICAL PROCEDURES

Aesthetic medical procedures should be supported by scientific evidence and/or have local medical expert consensus that the procedures are well-established and acceptable.

These procedures can be classified into non-invasive, minimally invasive and invasive as follows.

3.1 Classification of aesthetic medical procedures:

a) Non-invasive procedures

This is defined as external applications or treatment procedures that are carried out without creating a break in the skin or penetration of the integument. They target the epidermis only.

b) Minimally invasive procedures

This is defined as treatment procedures that induce minimal damage to the tissues at the point of entry of instruments. These procedures involve penetration or transgression of integument but are limited to the sub-dermis and subcutaneous fat; not extending beyond the superficial musculo- aponeurotic layer of the face and neck, or beyond the superficial fascial layer of the torso and limbs.

c) Invasive procedures

This is defined as treatment procedures that penetrate or break the skin through either perforation, incision or transgression of integument, subcutaneous and/or deeper tissues, often with extensive tissue involvement in both vertical and horizontal planes by various means, such as the use of knife, diathermy, ablative lasers, radiofrequency, ultrasound, cannulae and needles.

3.2 Safety concerns

All aesthetic procedures are not completely safe. Some of the complications commonly encountered include anaesthetic reactions, bleeding, infections, scarring, pigmentary changes (hypo- or hyper pigmentation) and even death. When a procedure has a potential for serious complications, it may be categorised as invasive even if it involves minimal damage to the skin.